Healthcare Provider Details

I. General information

NPI: 1689014359
Provider Name (Legal Business Name): NOOPUR TIWARI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL WAY
BUTLER PA
16001-4670
US

IV. Provider business mailing address

PO BOX 1549
BUTLER PA
16003-4679
US

V. Phone/Fax

Practice location:
  • Phone: 724-285-0823
  • Fax: 724-285-0879
Mailing address:
  • Phone: 724-285-0823
  • Fax: 724-285-0879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT203649
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD459597
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: